The purpose of this project is to reduce drinking among pregnant AI/AN women and women of childbearing age in a reservation community, in an effort to reduce the rate of Fetal Alcohol Spectrum Disorders (FASD), which occurs more frequently in AI/AN populations. Three specific aims are proposed to achieve this goal: 1) to deepen our understanding of drinking among pregnant women/women of childbearing age and the implications of this understanding for prevention practices in a reservation community; 2) utilizing a CBPR approach, assess the relevance, feasibility, and sustainability of evidence-based FASD preventive interventions in this reservation community; and 3) select one preventive intervention for adaptation and pilot testing on a small scale in preparation for a larger randomized control trial involving multiple reservation communities of the same tribal population. The research group will partner with a local AI/AN reservation community to conduct this work, using Community-Based Participatory Research (CBPR) methods as a guide for all work to be completed, including the involvement of a Community Advisory Board (CAB). SA1 will involve the use of focus groups and a qualitative analysis of findings which will be reviewed with the CAB, as well as a group of national experts on FASD prevention, in the service of selecting a promising existing evidence-based preventive intervention. Adaptations will be made to the chosen preventive intervention to make it relevant (e.g. culturally), feasible, and sustainable within this tribal community. The adapted intervention will be piloted with a small sample of women (n=10-20). Following the pilot, and any additional adaptations based on this pilot work, the team will work with this community and other tribally related communities to expand this work to a full-scale trial of the preventive intervention. This project promises to address an important health disparity (FASD) in an underserved group (AI/AN) that experiences multiple health disparities relative to the general U.S. and other racial group populations. If successful, this project will reduce the burden of disease borne by AI/AN populations with respect to FASD. PUBLIC HEALTH RELEVANCE: This project promises to address an important health disparity (Fetal Alcohol Spectrum Disorders; FASD) in an underserved group (American Indian and Alaska Natives; AI/AN) that experiences multiple health disparities relative to the general U.S. and other racial group populations. If successful, this project will reduce the burden of disease borne by AI/AN populations with respect to FASD. [unreadable] [unreadable] [unreadable]